Abstract:
BACKGROUND:Attending physicians are well positioned to identify medical errors and understand their consequences. The spectrum of errors that can be detected by attending physicians in the course of their usual practice is currently unknown. OBJECTIVES:To determine the frequency, types, and consequences of errors that can be detected by attending hospitalist physicians in the care of their patients, and to compare the types of errors first discovered by attending hospitalists to those discovered by other providers. DESIGN:Prospective identification of errors by attending physicians. SETTING:Two hundred-bed, academic hospital. PATIENTS:Five hundred twenty-eight patients admitted to the general medicine service from October 2000 to April 2001. MEASUREMENTS:Errors, both near misses and adverse events, were identified during the course of routine, clinical care by 2 attending hospitalists. Errors first detected by other health care workers were also recorded. MAIN RESULTS:Of the 528 patients admitted to the hospitalist service, 10.4% experienced at least 1 error: 6.2% a near miss and 4.2% an adverse event. Although differences did not achieve statistical significance, most of the errors first detected by house staff, nurses, and laboratory technicians were adverse events; most of the errors first detected by the attending hospitalists, pharmacists, and consultants were near misses. Drug errors were the most common type of error overall. CONCLUSIONS:Attending physicians engaged in routine clinical care can detect a range of errors, and differences may exist in the types of errors detected by various health care providers.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Chaudhry SI,Olofinboba KA,Krumholz HMdoi
10.1046/j.1525-1497.2003.20919.xsubject
Has Abstractpub_date
2003-08-01 00:00:00pages
595-600issue
8eissn
0884-8734issn
1525-1497pii
jgi20919journal_volume
18pub_type
杂志文章abstract:BACKGROUND:The Centers for Medicare & Medicaid Services (CMS)/Premier Hospital Quality Incentive Demonstration (HQID) project aims to improve clinical performance through a pay-for-performance program. We conducted this study to identify the key organizational factors associated with higher performance. METHODS:An inv...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-0997-6
更新日期:2009-07-01 00:00:00
abstract::A prospective study of 79 patients with recent hip fracture revealed prior functional impairments with community mobility (49%), using a bathtub (40%), walking outdoors (26%), and stair-climbing (18%). Eighty-six per cent of patients (mean age 77.9 years) were admitted from home, with 95% surviving to discharge but on...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596300
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Patients who leave hospitals against medical advice (AMA) may be at risk for adverse health outcomes. Their decision to leave may not be clearly understood by providers. This study explored providers' experiences with and attitudes toward patients who leave the hospital AMA. OBJECTIVE:To explore providers' ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0728-4
更新日期:2008-10-01 00:00:00
abstract::Chronic care facility stay has been shown to be an independent risk factor for venous thromboembolism. Review of the literature, however, reveals a paucity of data addressing the issue of venous thromboembolism in nursing home residents. The purpose of this study was to determine the incidence of venous thromboembolic...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2003.21133.x
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:The risk of adverse events among alcohol-interactive medication users can occur with one standard alcoholic drink. Research on the extent to which this occurs is scant. OBJECTIVE:To examine the prevalence and correlates of concurrent alcohol and alcohol-interactive (AI) medication use across different level...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0639-4
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Heterogeneity of existing physician burnout studies impairs analyses of longitudinal trends, geographic distribution, and organizational factors impacting physician burnout. The Department of Veterans Affairs (VA) is one of the largest integrated healthcare systems in the USA, offering a unique opportunity t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05582-7
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Obese women experience higher postmenopausal breast cancer risk, morbidity, and mortality and may be less likely to undergo mammography. OBJECTIVES:To quantify the relationship between body weight and mammography in white and black women. DATA SOURCES AND REVIEW METHODS:We identified original articles eval...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11606-009-0939-3
更新日期:2009-05-01 00:00:00
abstract::Increasing emphasis on value in health care has spurred the development of value-based and alternative payment models. Inherent in these models are choices around program scope (broad vs. narrow); selecting absolute or relative performance targets; rewarding improvement, achievement, or both; and offering penalties, r...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-017-4125-8
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Stigma is associated with depression treatment, however, whether stigma differs between depression treatment modalities is not known, nor have racial differences in depression treatment stigma been fully explored. OBJECTIVE:To measure stigma for four depression treatments and estimate its association with t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0276-3
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Healthcare providers use a life expectancy of at least 5 to 10 years in shared clinical decision-making with older adults about cancer screening, major surgeries, and disease prevention interventions. At present, few prognostic indexes predict long-term mortality beyond 10 years or are suited for use in prim...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06132-2
更新日期:2020-08-20 00:00:00
abstract:OBJECTIVE:In 1996, the Health Care Financing Administration (HCFA) introduced new evaluation and management (E&M) guidelines mandating more intensive supervision and documentation by attending physicians. We assessed the effects of the guidelines on inpatient teaching. DESIGN:Pretest-posttest, nonequivalent control gr...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1525-1497.2000.07001.x
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:To decrease unnecessary antibiotic use for acute respiratory tract infections in adults in a point-of-service health care setting. DESIGN:Prospective, nonrandomized controlled trial. SETTING:An urban urgent care clinic associated with the major indigent care hospital in Denver, Colorado between October 2000...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章
doi:10.1046/j.1525-1497.2003.20410.x
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:As the Veterans Health Administration (VHA) reorganizes providers into the patient-centered medical home, questions remain whether this model of care can demonstrate improved patient outcomes and cost savings. OBJECTIVE:We measured adoption of medical home features by VHA primary care clinics prior to wides...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-013-2405-5
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:The patient-centered medical home (PCMH) model is being implemented in health centers (HCs) that provide comprehensive primary care to vulnerable populations. OBJECTIVE:To identify characteristics associated with HCs' PCMH capability. DESIGN:Cross-sectional analysis of a national dataset of Federally Quali...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3729-8
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:To describe how medical residents discuss do-not-resuscitate (DNR) orders with patients. DESIGN:Prospective observational study. SETTING:Inpatient medical wards of one university tertiary care center, one urban city public hospital, and one Veterans Affairs medical center. PARTICIPANTS:Thirty-one medical r...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599915
更新日期:1995-08-01 00:00:00
abstract::Community health centers (CHCs) provide primary care for underserved children and adults. The Patient Protection and Affordable Care Act (ACA) aimed to strengthen the CHC network by increasing federal funds and expanding Medicaid eligibility. The ACA also aimed to boost preventive and mental health services and to red...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05571-w
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Patient-centered care--including the domains of access and communication--is an important determinant of positive clinical outcomes. OBJECTIVE:To explore associations between race and HIV-infected patients' experiences of access and communication. DESIGN:This was a cross-sectional survey. PARTICIPANTS:Nin...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-008-0788-5
更新日期:2008-12-01 00:00:00
abstract::We surveyed employers of general internists at teaching hospitals to determine whether they prefer that new hires are graduates of general internal medicine (GIM) fellowships. We surveyed former GIM fellows who graduated between 1988 and 1994 to determine whether they found jobs with protected research time and whethe...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00121.x
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:In response to the landmark report "Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering," the NIH Office of Research on Women's Health issued a request for applications that funded 14 R01 grants to investigate causal factors to career success for women in STEM. Fol...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-018-4547-y
更新日期:2019-03-01 00:00:00
abstract::Hepatitis C virus (HCV) infection is a significant health problem worldwide, and is the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation in the United States. The management of HCV has changed significantly over the last 5 years, as treatments have become simpler and more efficacious. Me...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-017-4280-y
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:As healthcare reimbursement shifts from being volume to value-focused, new delivery models aim to coordinate care and improve quality. The patient-centered medical home (PCMH) model is one such model that aims to deliver coordinated, accessible healthcare to improve outcomes and decrease costs. It is unclear...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-019-05594-3
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Concern about the link between clinical supervision and safe, quality health care has led to widespread increases in the supervision of medical trainees. The effects of increased supervision on patient care and trainee education are not known, primarily because the current multifacted and poorly operationali...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0179-3
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:The transition from pediatric to adult care is a critical period for young adults with childhood-onset conditions. General internists are tasked with participating in the care of this vulnerable population. Existing guidelines regarding transition do not fully address structural or organizational characteris...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-019-05226-w
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Pay for performance (P4P) programs have shown only modest improvements in outcomes and do not target patient behaviors. Many large employers and payers are turning to pay for performance for patients (P4P4P) to reduce health costs and improve the health of their covered populations. How these programs may be...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0739-1
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To measure and compare patient satisfaction with care in resident and attending physician internal medicine ambulatory care clinics. DESIGN:A cross-sectional survey using a questionnaire derived from the Visit-Specific Satisfaction Questionnaire (VSQ) and Patient Satisfaction Index (PSI) distributed from Mar...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2001.91005.x
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVE:African-American (black) and white individuals have been shown to differ in their desire for life-sustaining treatments and their use of living wills for end-of-life care, but the reasons for these differences are unclear. This study was designed to test the hypothesis that these ethnic differences exist beca...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600155
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:Translating lessons from clinical trials on the prevention or delay of type 2 diabetes to populations in nonstudy settings remains a challenge. The purpose of this paper is to review, from the perspective of practicing clinicians, available evidence on lifestyle interventions or medication to prevent or delay...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1111/j.1525-1497.2005.0277.x
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:1) To determine whether the frequencies of panic disorder (PD) and depression (DEP) in an emergency department (ED) population were comparable to those in other primary care groups; 2) to evaluate whether patients without the clinical diagnosis of acute cardiac ischemia (ACI) had higher frequencies of these d...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600087
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Although intrinsic motivating factors play important roles in physician well-being and productivity, most studies have focused on extrinsic motivating factors such as salary and work environment. OBJECTIVE:To examine the association of intrinsic motivators with physicians' career satisfaction, life satisfac...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-017-3997-y
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:The Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) seeks to develop partnerships between VA health services researchers and clinical managers, with the goal of designing and evaluating interventions to improve the quality of VA health care. METHODS:In the present report we describe one...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-1155-x
更新日期:2010-01-01 00:00:00